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HEMATOLOGY 1

Total questions: 30

Worksheet time: 19mins

Name
Class
Date
1.

A membrane-associated ecto-adenosine diphosphatase (ADPase) found on surface of endothelial cells that degrades ADP released from activated platelets.

a)

CD41

b)

ADAMST13

c)

CD39

d)

ADAMTS13

2.

Critical enzyme/s in the biosynthesis of thromboxane A2 which is/are irreversibly actylated by aspirin.

a)

COX-1

b)

COX-2

c)

COX 1 and 2

d)

VWF

3.

The ADP receptor antagonists include the thienopyridines (clopidogrel and prasugrel) as well as ticagrelor and cangrelor. All of these drugs target the key ADP receptor on platelets called ______.

a)

ADAMTS13

b)

ADAMST13

c)

P2Y2

d)

P2Y12

e)

VWF

4.

It is an orally active inhibitor of P2Y12, this drug differs from the thienopyridines in tha it does not require metabolic activation and it produces reversible inhibition of the ADP receptor.

a)

DIPYRIDIMOLE

b)

CLOPIDOGREL

c)

TICAGRELOR

d)

CANGRELOR

5.

It is a relatively weak antiplatelet agent on its own, but an extended-release formulation of this drug combined with low-dose aspirin, a preparation known as Aggrenox, is used for prevention of stroke in patients with transient ischemic attacks.

a)

CANGRELOR

b)

PRASUGREL

c)

DIPYRIDAMOLE

d)

CLOPIDOGREL

6.

It is an orally active PAR-1 antagonist, which is slowly eliminated with a half-life of about 200 h.

a)

tirofiban

b)

vorapaxar

c)

eptifibatide

d)

abciximab

7.

GP IIB/IIIA RECEPTOR ANTAGONISTS

a)

abciximab

b)

eptifibatide

c)

tirofiban

d)

vorapaxar

8.

Heparin-induced thrombocytopenia (HIT) is an antibody-mediated process that is triggered by antibodies directed against neoantigens on _________ that are exposed when heparin binds to this protein

a)

PF1

b)

PF2

c)

PF3

d)

PF4

9.

Thrombocytopenia in HIT should be suspected when.....

a)

Platelet count of ≤100,000/μL

b)

decrease in platelet count of ≥50% from pretreatment level

c)

both

d)

only suspected clinically

10.

In HIT, platelet count usually falls how many days after starting heparin?

a)

1-3 days

b)

3-6 days

c)

5-10 days

d)

1-2 weeks

11.

Heparin-associated osteoporosis is expected if treatment is

a)

>4 months

b)

>3 months

c)

>2 months

d)

> 1month

12.

A synthetic analogue of the antithrombin-binding pentasaccharide sequence and is licensed for thromboprophylaxis in general medical or surgical patients and in high-risk orthopedic patients and as an alternative to heparin or LMWH for initial treatment of patients with established venous thromboembolism.

a)

Enoxaparin

b)

Fondaparinux

c)

Bivalirudin

d)

Argatroban

13.

Warfarin has a narrow therapeutic window, frequent coagulation monitoring is essential to ensure that a therapeutic anticoagulant response is maintained. Even patients with stable warfarin dose requirements should have their INR determined every__________ weeks.

a)

1-2

b)

2-3

c)

3-4

d)

4-6

14.

Warfarin is administered in doses that produce a target INR of 2.0–3.0. An exception is patients with mechanical heart valves, particularly those in the mitral position or older ball and cage valves in the aortic position, where a target INR of ______________ is recommended.

a)

2-4

b)

2.5-3.5

c)

3-4

d)

3.5-4.5

15.

It is a two-chain serine protease derived from cultured fetal kidney cells with a molecular weight of 34,000. This drug converts plasminogen to plasmin directly by cleaving the Arg560-Val561 bond.

a)

Alteplase

b)

Urokinase

c)

Tenecteplase

d)

Streptokinase

16.

It is a single-chain, recombinant tPA derivative that lacks the finger, epidermal growth factor, and first kringle domains. This truncated derivative has a molecular weight of 39,000. Reteplase binds fibrin more weakly than tPA because it lacks the finger domain. It is produced in Escherichia coli.

a)

Reteplase

b)

Tenecteplase

c)

Streptokinase

d)

Alteplase

17.

It is a genetically engineered variant of tPA and was designed to have a longer half-life than tPA and to be resistant to inactivation by PAI-1.

a)

Alteplase

b)

Tenecteplase

c)

Urokinase

d)

Streptokinase

18.

Warfarin does not pass into the breast milk. Consequently, warfarin can safely be given to nursing mothers.

a)

TRUE

b)

FALSE

19.

A common complication of warfarin, skin necrosis usually is seen 2–5 days after initiation of therapy

a)

TRUE

b)

FALSE

20.

The risk of embryopathy is highest if warfarin is given in the second trimester of pregnancy

a)

TRUE

b)

FALSE

21.

Factor II is also known as

(a)  

22.

To calculate the INR, the patient’s prothrombin time is divided by the mean normal prothrombin time, and this ratio is then multiplied by the ISI( ranging from 0.9 to 1.4). ISI stands for...

(a)  

23.

The key ADP receptor on platelets targeted by thienopyridines (clopidogrel and parugrel).

(a)  

24.

Most widely used antiplatelet agent worldwide

(a)  

25.

It is the most abundant receptor on the platelet surface, undergoes a conformational change that enables it to bind fibrinogen and, under high shear conditions, VWF

(a)  

26.

GP IIB/IIIA RECEPTOR ANTAGONISTS

a)

abciximab

b)

tirofiban

c)

eptifibatide

d)

all oif the above

27.

Before a major surgery, clopidogrel and prasugrel must be stopped at least how many days?

(a)  

28.

A synthetic 20-amino-acid analogue of hirudin, s a divalent thrombin inhibitor.

It is licensed as an alternative to heparin in patients undergoing percutaneous coronary intervention. This drug was also has been used successfully in HIT patients who require percutaneous coronary intervention or cardiac bypass surgery.

(a)  

29.

In HIT arterial thrombosis is more common than venous thrombosis.

a)

True

b)

False

30.

Fondaparinux does not cause HIT because it does not bind to PF4.

a)

True

b)

False